Individual
DR. CHARLES R DUFORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1300 ESTHER ST, SUITE 101, VANCOUVER, WA 98660-2889
(360) 693-4701
(360) 993-5299
Mailing address
1300 ESTHER ST, SUITE 101, VANCOUVER, WA 98660-2889
(360) 693-4701
(360) 993-5299
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
7233
OR
1223P0700X
Prosthodontics
Primary
8233
WA
Other
Enumeration date
08/19/2006
Last updated
07/08/2007
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